Dealing with post-traumatic stress disorder (PTSD)

Millions of Americans suffer from post-traumatic stress disorder (PTSD). Read on to learn more about what PTSD is, who it affects, and what can be done about it.

What is post-traumatic stress disorder (PTSD)?

PTSD is a disorder that some veterans develop after having experienced a shocking, scary, or dangerous event.

It is natural to feel afraid during and after a traumatic situation. This fear triggers many split-second changes in the body to help a person respond to immediate danger and then avoid danger in the future. This “fight-or-flight” response is a typical reaction meant to protect humans from harm. Nearly everyone will experience a range of reactions after a traumatic event. Over time, most people will recover from those symptoms naturally. However, people who have PTSD continue to feel stressed or frightened, even when they are no longer in danger.

Who develops PTSD?

Anyone can develop PTSD at any age. This includes war veterans, but it can also include survivors of other trauma, such as physical or sexual assault, abuse, car accidents, disasters, terror attacks, and other traumatic events. According to the National Center for PTSD, about seven or eight of every 100 people will experience PTSD at some point in their lives.

PTSD and military veterans

Many veterans have experienced the trauma associated with combat and other horrible, life-threatening events while in the military. These events can lead to the development of PTSD.

The U.S. Department of Veterans Affairs estimates that PTSD afflicts:

Almost 31 percent of Vietnam veterans

As many as 10 percent of Gulf War (Desert Storm) veterans

11 percent of veterans of the war in Afghanistan

20 percent of Iraqi war veterans

What are the symptoms of PTSD?

Symptoms can appear at any time, but they usually begin within three months of the traumatic incident. For symptoms to be considered PTSD, they must last more than a month and be severe enough to interfere with daily life functions, such as work or relationships with others.The course of the disorder varies from person to person. Some people recover within six months. Some have symptoms that last much longer. For yet others, the condition becomes chronic (that is, ongoing).

Re-experiencing symptoms

Flashbacks—reliving the trauma over and over. Flashbacks can include physical symptoms, such as sweating or a racing heart.

Bad dreams

Frightening thoughts

Re-experiencing symptoms can cause problems in a person’s daily routine. They can start from the person’s own thoughts and feelings. Words, objects, or situations that are reminders of the event can also trigger re-experiencing symptoms.

Avoidance symptoms

Staying away from places, events, or objects that are reminders of the experience

Avoiding thoughts or feelings related to the traumatic event

Things or situations that remind a person of the traumatic event can trigger avoidance symptoms. These symptoms can cause a person to change his or her personal routine. For example, after a serious car accident, a person who usually drove might avoid driving again or riding in a car.

Arousal and reactivity symptoms

Being easily startled

Feeling tense or “on edge”

Having difficulty sleeping, and/or having angry outbursts

Instead of being triggered by something that brings back memories of the traumatic event, arousal symptoms are usually constant. They can make the person with PTSD feel stressed and angry. These symptoms can make it hard to sleep, eat, or concentrate, and disrupt other normal daily activities.

Cognition and mood symptoms

Trouble remembering key features of the traumatic event

Negative thoughts about oneself or the world

Distorted feelings like guilt or blame

Loss of interest in enjoyable activities

Cognition and mood symptoms can begin or worsen after the traumatic event. These symptoms can make a person feel alienated or detached from friends or family members.

How is PTSD diagnosed?

A doctor who has experience helping people with mental illnesses, such as a psychiatrist or psychologist, can diagnose PTSD.

To be diagnosed with PTSD, an adult must have all of the following for at least one month:

At least one re-experiencing symptom

At least one avoidance symptom

At least two arousal and reactivity symptoms

At least two cognition and mood symptoms

How is PTSD treated?

It is important for anyone with PTSD to be treated by a mental health professional who is experienced with PTSD. The main treatments are psychotherapy (“talk” therapy), medications, or both. However, everyone is different, and PTSD affects people differently, so a treatment that works for one person might not work for another. People with PTSD need to work with a mental health professional to find the best treatment for their symptoms.

If someone with PTSD is living through an ongoing trauma, such as being in an abusive relationship, both of the problems need to be addressed. Other ongoing problems can include panic disorder, depression, substance abuse, and feeling suicidal. Research shows that support from family and friends can be an important part of recovery.

How can I help a friend or relative who has PTSD?

If you know someone who might be experiencing PTSD, the first and most important thing you can do is to help him or her seek help, in order to get the right diagnosis and treatment. Help the person make an appointment with the right doctor, and then visit the doctor together for added support. Encourage the person to stay in treatment, or to seek different treatment if symptoms don’t get better after six to eight weeks.

You can also:

Offer emotional support, understanding, patience, and encouragement.

Learn more about PTSD, so you can understand what your friend or relative is experiencing.

Listen carefully. Pay attention to his or her feelings and the situations that might trigger PTSD symptoms.

Share positive distractions, such as walks, outings, and other enjoyable activities.

Remind your friend or relative that, with time and treatment, he or she can get better.

NEVER ignore comments about death or a desire to die.

Contact your friend’s or relative’s therapist or doctor for help, or call the National Suicide Prevention Lifeline (1-800-273-8255) or 911 in an emergency.

How can I help myself?

If you are experiencing symptoms of PTSD, it might be very difficult to take that first step toward helping yourself. However, it is important to realize that — although it might take some time — with treatment, you can get better.

Here are some ways you can help yourself:

Talk with your doctor about treatment options.

Engage in mild physical activity or exercise to help reduce stress.

Set realistic goals for yourself.

Break up large tasks into small ones, set some priorities, and do what you can as you can.

Try to spend time with other people and confide in a trusted friend or relative.

Tell others about things that may trigger symptoms.

Expect your symptoms to improve gradually, not immediately.

Identify and seek out comforting situations, places, and people.

Where can I go for help?

If you are unsure of where to go for help, ask your family doctor or visit NIMH’s Help for Mental Illnesses page (www.nimh.nih.gov/findhelp) for more resources.

Information courtesy of the National Institutes of Health and the U.S. Department of Veterans Affairs.